AMA: Anti-competitive conditions exist in 4 out of 5 health insurance markets

Mergers and acquisitions in the commercial health insurance market have elbowed out any real competition in four out five metropolitan areas, the American Medical Association said Tuesday.

The AMA also announced its release of an analysis, which reports commercial health insurance market shares and federal concentration measures for 368 metropolitan markets and 48 states.

"New data presented by the AMA demonstrates the degree of anti-competitive market clout that some health insurers have gained through mergers and acquisitions," said AMA President Peter W. Carmel , M.D. "Our new report is intended to help regulators, lawmakers, researchers and policymakers identify markets where mergers among health insurers may cause competitive harm to patients, physicians and employers."

The association is charging non-members $150 to purchase the report, and is offering it free to members.

Among the report findings:

  • A significant absence of health insurer competition exists in 83 percent of metropolitan markets studied by the AMA. These markets rated "highly concentrated," based on the newly revised Horizontal Merger Guidelines issued last year by the U.S. Department of Justice and Federal Trade Commission*.
  • In about half of metropolitan markets, at least one health insurer had a commercial market share of 50 percent or more.
  • In 24 of the 48 states reported in the new AMA study, the two largest health insurers had a combined commercial market share of 70 percent or more.
  • The 10 states with the least competitive commercial health insurance markets, are: 1. Alabama, 2. Alaska, 3. Delaware, 4. Michigan, 5. Hawaii, 6. District of Columbia, 7. Nebraska, 8. North Carolina, 9. Indiana and 10. Maine.

To order the study, visit the AMA Bookstore online, or call (800) 621-8335 and mention item number OP427111.

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